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Benefits Auditing

Accounting Firm Required Pharmacy Expertise

Industry	Benefits Auditing
Problem	A Top Ten accounting firm sought out PHSI for insight and assistance in the auditing process of a prescription benefits plan. The audit process required expert knowledge on prescription claims and manufacturer rebates.
PHSL Solution	PHSI collaborated on a strategic action plan to identify critical elements to review when examining prescription claims and rebates. PHSI assisted in reviewing claims while on site with the benefit manager and provided expert opinions on the prescription benefits plan. PHSI offered guidance throughout the entire auditing process and contributed to the final written reports to ensure accuracy.
Results	The knowledge and experience offered by PHSI allowed the auditing process to be accomplished more efficiently and leveraged the accounting firm’s resources.

May 2023 Question of the Month

Which type of project(s) could you or your organization most benefit from in 2023?

Future forecast: 0%

Competitor comparison: 20%

Contract variance analysis: 20%

Historical trend analysis: 20%

Legislative/regulatory impact: 0%

Procurement cost/savings: 20%

Stakeholder program impact: 20%

April 2023 Question of the Month

In July 2022, the FDA proposed expanding the NDC to a uniform 12 numeric digit format to accommodate future needs when all options using the current formats have been exhausted. Alternative options shared by the industry have asked the FDA to consider retaining the current NDC formats and allow the use of alpha characters when all numeric options have been exhausted.

Which of the following transition types is your organization prepared for in the next 5 years?

Make the transition to alphanumeric using the current NDC formats: 70%

Make the transition to the 12-digit numeric format: 20%

Make the transition to neither option: 10%

Make the transition to either option: 0%

March 2023 Question of the Month

What information would you most like to gain from an Online Listening Assessment for a particular drug therapy or device? (Multiple selections allowed)

Prescribing & Dispensing Concerns: 25%

Competitor Comparisons: 25%

Prescribing Information Alignment: 17%

Coverage & Reimbursement: 17%

Patient Affordability: 8%

Misinformation: 8%

Disease State Concerns: 0%